Year of Publication

2018

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Education

Department

Early Childhood, Special Education, and Rehabilitation Counseling

First Advisor

Dr. Malachy Bishop

Abstract

Participation is generally considered the ultimate rehabilitation outcome and, for individuals with progressive illnesses, elucidating the factors that impact participation is critical. Parkinson’s disease (PD) is a chronic degenerative, neurological condition affecting nearly 1 million people in the United States, making PD the second most prevalent neurodegenerative disorder. PD has a profound negative effect on functioning and activity, but limited literature exists assessing the relationship between PD and community participation. The purpose of this study was to use the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) as a framework for explaining how PD affects participation. Additionally, because the ICF explains the impact of chronic illness and disability as consisting of interactions between different contextual and disease-related factors, this investigation also addressed whether the personal factors, Positive Psychological Capital (PsyCap), mediated the relationship between functioning with PD and community participation.

A total of 114 individuals were surveyed from peer-led PD support groups in a Midwestern state. The study examined the individual and collective contributions of demographic characteristics, activities/functioning, environmental factors, and personal factors on community participation. Results from the hierarchical regression analysis suggest that demographic characteristics account for only 15% of the variance in participation, but when functioning was added to the model, 65% of the variance was accounted for. The addition of environmental and personal covariates did not result in any significant change in overall variance in participation. These results, along with the strong, positive linear correlations between functioning and participation (r = .78), indicate that functioning largely predicts an individual’s participation. The study also sought to identify any mediating effect of personal factors (PsyCap) on the relationship between functioning and participation. The results indicated that the completely standardized indirect coefficient was not significant, b = .065, SE = .0617, 95% CI = -.213, .029, with 0 falling within the CI, which confirms no significant effect of the mediator PsyCap.

The study contributes new knowledge to the association between the symptoms associated with PD and one’s community participation. Clearly, functioning is the primary predictor of participation. The lack of mediation of PsyCap, again, supports the strength of the relationship between functioning and participation. Although PsyCap did not mediate the relationship, implications for future research are discussed.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2018.283

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